February 3, 2010

experts comment on new research investigating brain activity in disorders of consciousness, as published in the New England Journal of Medicine

Scientists have claimed to have shown the first evidence of a ‘conversation’ held with a patient in a vegetative state using brain scanning technology, suggesting that patients who were thought to be unresponsive could have more awareness than previously thought.

“These findings have extremely broad implications, not just for concerns about the accurate assessment of vast numbers of patients in custodial care situations, but in the context of any clinical encounter where we currently rely on behavioral assessment alone to identify consciousness.

“It is important, however, to appreciate the complexity of these measurements and assessments of such severely brain injured patients. Obtaining this type of result is only starting point and creates urgency to further investigate and assist such patients.

“The most important question left unanswered by these findings is what mechanism accounts for the stunning dissociation of behavior and integrative brain function. I think we can be sure that as the biological answers underlying this question become more clear, this will have a profound impact across medicine.”

“Adrian Owen and his group have previously used brain imaging measures to show that a patient in a vegetative state was conscious. They have now gone a huge step further and shown that a patient previously assumed to be in a vegetative state could use his thoughts, as reflected in brain activity, to give yes or no answers to questions. This is even stronger proof of consciousness. It is difficult to imagine a worse experience than to be a functioning mind trapped in a body over which you have absolutely no control. Obviously, more technical development is required, but we now have the distinct possibility that, in the future, thanks to Owen and colleagues’ work we will be able to detect cases of other patients who are conscious and what’s more, we will be able to communicate with them.”